How does a foreign health insurance company check our medical history?

[The Dude Abides]

Has anyone from the UK/US or anywhere else had to give access to your entire NHS/Medicare records?

If not, I don't understand how they can check into your past medical history.

[scubascuba3]

For a travel insurance claim they ask for your doctor in UK and contact them.

When i applied for heath insurance they ask for your medical history, i imagine in a claim they start digging

[Puchaiyank]

Application form that I have used ask detailed questions surgeries, procedures, and imaging...medicines, doctors and more...

 

Be careful if you get a physical to purchase insurance...went to local hospital as lab work and x-ray required...young doctor...1st question..."do you speak Thai"...well, no...it all went downhill from there...wrote up a damming report adding illnesses which my US doctors had never discovered...he added with glee...obese...policy denied...which is the first question on any policy..."have you ever been denied insurance?" 

 

It was a good policy at a fair price...Thai doc is so proud to send another farang packing...

[Sheryl]

It is not normally requested when getting a policy except if there are concerns regarding a specific past or current condition in which case you may be asked to provide medical records and lab test reports etc specific to that condition so that the underwriters can better determine if there is an above average risk present and to what degree.

When you make a claim they do not usually ask for more than the medical records related to that claim but they may ask for older ones if they suspect pre existing conditions were a factor. This is most likely to happen with claims for illness (as opposed to accident) filed in the first year or two of the policy and for conditions which by their nature are likely to have pre-existed for some time.

In addition your current medical record for the current illness will include past medical history as you provided it to the doctor. This will certainly cover common chronic diseases like diabetes, hypertension etc. And if you are thinking of lying to the doctors who treat you in order to keep something off your chart keep in mind it could endanger you and result in improper treatment.

Any falsification on your application can invalidate your entire policy. Don't do it.

From experiences people have reported here insurance companies vary greatly in how they handle the same pre-existing condition so it is worth applying to several, the fact that one refused you does not necessarily mean they all will. It is also possible if insured with exclusions to get the exclusion lifted at a later time if you have been free of symptoms and not needed further treatment.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[The Dude Abides]

12 hours ago, Sheryl said:

It is not normally requested when getting a policy except if there are concerns regarding a specific past or current condition in which case you may be asked to provide medical records and lab test reports etc specific to that condition so that the underwriters can better determine if there is an above average risk present and to what degree.

"

In addition your current medical record for the current illness will include past medical history as you provided it to the doctor. This will certainly cover common chronic diseases like diabetes, hypertension etc. And if you are thinking of lying to the doctors who treat you in order to keep something off your chart keep in mind it could endanger you and result in improper treatment.

Any falsification on your application can invalidate your entire policy. Don't do it.

From experiences people have reported here insurance companies vary greatly in how they handle the same pre-existing condition so it is worth applying to several, the fact that one refused you does not necessarily mean they all will. It is also possible if insured with exclusions to get the exclusion lifted at a later time if you have been free of symptoms and not needed further treatment.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

I read on some sites posters mentioning a 2 year period for the insurer - perhaps that was for life insurance - that they can ask for further past history info.

But it sounds like this is incorrect.

 

Have insurers ever asked for the complete medical claims of the insured from NHS or Medicare or a like body? Or do they not go that far and only ask if the insured ever had X previously, when confronted with a new claim?

 

"When you make a claim they do not usually ask for more than the medical records related to that claim but they may ask for older ones if they suspect pre existing conditions were a factor."

 

But if living in Thailand and all previous medical history was in a foreign country, how would the insurer know what older claims if any exist for the medical situation at hand?

It seems like they would have to ask for the person's entire NHS claims record, but I don't know if they ever go that far or if the NHS would accept that even if the insured person gave written permission.

Has anyone here ever experienced that?

 

 

[uhuh]

5 hours ago, The Dude Abides said:

 

Have insurers ever asked for the complete medical claims of the insured from NHS or Medicare or a like body? Or do they not go that far and only ask if the insured ever had X previously, when confronted with a new claim?

 

They do go that far.  If the claim is high enough,  they go even much further. 

For claims of hundreds of thousands of USD (not so unusual), they will contact embassies and ask about this hospital,  they will contact airlines and request passenger manifestos, they ask Social Security, family doctors, family and friends under false pretences about the medical history of the patient,  they will hire detectives and so on. 

Of course,  embassies,  airlines or NHS may not necessarily cooperate with the insurance. Family doctors often don't cooperate with insurances.

So the easiest thing for the insurance is just to delay payment, they will always find a reason,  if they are lucky the patient dies. 

And if a 60- year-old says he was never sick and never saw a doctor they just don't believe it, so they don't pay.  "Sue us if you can!"

 

[scubascuba3]

I had a travel insurance claim a few weeks ago, i had to give permission that they contact my doctor, they checked for pre existing and then approved the claim and that was for just £180.

One of the risks with health insurance, if you don't disclose it they may deny the claim then your premiums have been a waste.

i recently didn't follow through with a health insurance quote. They weren't specific enough with their exclusions i.e. i have a migraine maybe once a year, they excluded anything connected with it unless i pay a 30% premium. "Anything connected" is just a too vague capture all term

[snowballthecat]

When you  walk into any private hospital ,in Thailand, the different doctors, specialities, will ask you about your previous conditions, history, etc and write it into a computer. Never mind who pays for that visit. Then one day, you will be recovered for an accident, let's say. At the time of discharge, the insurance has to pay the bill. They will ask the hospital (and all five private /public hospitals in that city),  to send ALL YOUR Medical record to the insurance. Symptoms and conditions, all. 

 

It happened to me. By chance I discovered in the invoice for the accident some annotations about some "findings" in a complete different specialisation, a private consultation paid enterely by myself, a year earlier. 

 

When asked the hospital about it.....here you go. 

They are allowed by law to talk about any of your conditions, no privacy whatsoever.

 

Private insurances have indeed two hospital workers doing full time work for insurers in each hospital, in Phuket International it is the case. They sit all day collecting data about patients and typing/interpreting/scanning for the insureres. 

 

So, better you disclose it all to the insurer, and every time there is a little "finding", also disclose it and let the insurance update your file. If you want to be covered at the time of the claim....

 

[JimmyJ]

14 hours ago, scubascuba3 said:

I had a travel insurance claim a few weeks ago, i had to give permission that they contact my doctor, they checked for pre existing and then approved the claim and that was for just £180.

One of the risks with health insurance, if you don't disclose it they may deny the claim then your premiums have been a waste.

i recently didn't follow through with a health insurance quote. They weren't specific enough with their exclusions i.e. i have a migraine maybe once a year, they excluded anything connected with it unless i pay a 30% premium. "Anything connected" is just a too vague capture all term

"I had a travel insurance claim a few weeks ago, i had to give permission that they contact my doctor, they checked for pre existing and then approved the claim and that was for just £180."

 

They checked with the doctor who treated you while you were traveling?

If that's the case, he would only be able to report what you told him of your previous history.

[scubascuba3]

"I had a travel insurance claim a few weeks ago, i had to give permission that they contact my doctor, they checked for pre existing and then approved the claim and that was for just £180."
 
They checked with the doctor who treated you while you were traveling?
If that's the case, he would only be able to report what you told him of your previous history.

i provided invoices to the claims team, they contacted my GP in the UK to see if a pre-existing condition

[The Dude Abides]

6 hours ago, scubascuba3 said:

 

 

i provided invoices to the claims team, they contacted my GP in the UK to see if a pre-existing condition

I guess that when you signed up for the travel insurance they asked for the info on your GP and you provided it, so they already knew about him before you made your claim?

 

 

[scubascuba3]

I guess that when you signed up for the travel insurance they asked for the info on your GP and you provided it, so they already knew about him before you made your claim?
 
 

You provide the GP details when you claim